Although some advocates want to lower the legal drinking age from 21, research continues to show that the law saves lives. That's the finding of a new review published in a special supplemental issue to the Journal of Studies on Alcohol and Drugs.
Researchers found that studies done since 2006 - when a new debate over age-21 laws flared up - have continued to demonstrate that the mandates work. The laws, studies show, are associated with lower rates of drunk-driving crashes among young people. And it seems they also curb other hazards of heavy drinking - including suicide, dating violence and unprotected sex.
"The evidence is clear that there would be consequences if we lowered the legal drinking age," said lead researcher William DeJong, Ph.D., of Boston University School of Public Health.
The U.S. legal-drinking age has had a winding history. In the early 1970s, 29 states lowered their legal drinking age to 18, 19 or 20. But after a rise in drunk-driving crashes among young people, many states began to reverse course. A change in federal law eventually pushed all states to adopt a minimum drinking age of 21 by 1988.
But in recent years, the benefits of the age-21 law have been challenged.
In 2006, a non-profit called Choose Responsibility started campaigning for a change in the federal law. Two years later, a group of more than 100 U.S. university presidents and chancellors known as the Amethyst Initiative called for a re-evaluation of the legal drinking age - citing a "clandestine" culture of heavy drinking episodes among college students as one reason that the age-21 law is not working.
Those moves grabbed a lot of media attention, and public health experts responded by launching new studies into the impact of the drinking-age law. Based on DeJong's review, that research supports what earlier work had shown: Since the legal drinking age was set at 21, young people have been drinking less and are less likely to get into drunk-driving crashes.
In one study, researchers found that, in 2011, 36 percent of college students said in the past two weeks they'd engaged in heavy episodic drinking (five or more drinks in a sitting, sometimes called "binge" drinking). That compared with 43 percent of students in 1988, the first year that all U.S. states had an age-21 law. There was an even bigger decline among high school seniors - from 35 percent to 22 percent.
Of course, many young people break the law and drink anyway. But, DeJong said, the evidence shows that the law is working despite that. That may be, in part, because minors do not want to be caught drinking, and therefore take fewer risks - like getting behind the wheel.
Plus, DeJong said, "there are many young people who do wait until they're 21 to drink."
DeJong said that education can help discourage underage drinking. Often, youths buy into the myth, for instance, that all college students engage in heavy drinking episodes. So giving them a more realistic picture of the true "drinking norms" can be effective, DeJong explained.
And, he said, tougher enforcement of the age-21 law, rather than a repeal, is what's needed. "Just because a law is commonly disobeyed doesn't mean we should eliminate it," DeJong noted. Clinical trials have found that when college towns put more effort into enforcing the law - and advertise that fact to students - student drinking declines.
"Some people assume that students are so hell-bent on drinking, nothing can stop them," DeJong said. "But it really is the case that enforcement works."